One Health and Emerging Infectious Diseases: Clinical Perspectives.

Abstract

To date, there has been little articulation of specific One Health clinical activities for veterinary and human health care providers regarding emerging infectious diseases, yet they could play a critical role. Under current clinical paradigms, both human and animal health professionals routinely diagnose and treat zoonotic infectious diseases in their patients, but tend to work in parallel with little cross-professional communication or coordination of care. For this to evolve toward a One Health model, both types of clinicians need to see how individual cases can be “sentinel events” indicating environmental risk for disease emergence, and develop mechanisms of rapid communication about these risks. Human and animal clinicians also need to take a more proactive and preventive approach to zoonotic diseases that includes the occupational health of animal workers in farms, laboratories, veterinary clinics, and other settings, as well as the recognition of increased risk among immunocompromised individuals in contact with animals. This requires training in One Health clinical competencies including the ability to diagnose and treat zoonotic diseases, implement preventive care interventions for individual patients, provide occupational health services for animal workers, recognize sentinel cases, report cases to public heath and clinical colleagues, and assess and help to intervene with environmental factors driving infectious disease risk in humans and animals. To provide an evidence base for such competency training, there is a need for development and testing of innovative protocols for One Health clinical collaborations.

Links among human health, animal health, and ecosystem health.

Abstract

In the face of growing world human and animal populations and rapid environmental change, the linkages between human, animal, and environmental health are becoming more evident. Because animals and humans have shared risk to health from changing environments, it seems logical to expand the perspective of public health beyond a single species to detect and manage emerging public health threats. Mitigating the effects of climate change, emerging pathogens, toxicant releases, and changes in the built environment requires a retooling of global public health resources and capabilities across multiple species. Furthermore, human and animal health professionals must overcome specific barriers to interprofessional collaboration to implement needed health strategies. This review outlines the relationships between human, animal, and ecosystem health and the public health challenges and opportunities that these links present.

Scotch, Matthew

Summary: Web 2.0 and the Semantic Web (3.0) provide great opportunities for biomedical informatics research and the development of informatics tools and resources to address problems across the full spectrum of health science research. One example is ZooPhy, an automated workflow for phylogeography. This system may be useful for epidemiologists who conduct surveillance and analysis of zoonotic (animal-human) agents. In addition to genetic, taxonomic, and geographical data, ZooPhy will include traditional public-health data collected by health departments. Through phylogenetics, data-mining, and machine-learning approaches, this system may help epidemiologists better understand the migration of various zoonotic diseases in animal hosts, estimate of the viral population growth within these hosts, and calculate risk to humans within a defined geographic area.

The USGS National Wildlife Health Center is pleased to announce the publication of Circular 1285 — Disease Emergence and Resurgence: The Wildlife-Human Connection. This book was prepared in cooperation with the U.S. Fish and Wildlife Service. Major funding support was provided by the U.S. Fish and Wildlife Service, Division of Federal Assistance, Administrative Grant No. AP95-017.

Abstract: Human-Animal Medicine focuses on the emerging diseases that cross between animals and humans, and points out the important environmental changes related to land use, climate change, intensification of food production, and other factors that help manifest these diseases. This evidence-based practice manual is designed to help you manage a wide range of clinical problems at the intersection of human and animal health, with practical steps for implementing the concept of “One Health” in daily practice of human and veterinary medicine and public health. Develop all the skills you need to effectively manage human-animal health problems with this timely, comprehensive resource.

Abstract: In order to identify priorities for building integrated surveillance systems that effectively model and predict human risk of zoonotic diseases, there is a need for improved understanding of the practical options for linking surveillance data of animals and humans. We conducted an analysis of the literature and characterized the linkage between animal and human health data. We discuss the findings in relation to zoonotic surveillance and the linkage of human and animal data. METHODS: The Canary Database, an online bibliographic database of animal-sentinel studies was searched and articles were classified according to four linkage categories. RESULTS: 465 studies were identified and assigned to linkage categories involving: descriptive, analytic, molecular, or no human outcomes of human and animal health. Descriptive linkage was the most common, whereby both animal and human health outcomes were presented, but without quantitative linkage between the two. Rarely, analytic linkage was utilized in which animal data was used to quantitatively predict human risk. The other two categories included molecular linkage, and no human outcomes, which present health outcomes in animals but not humans. DISCUSSION: We found limited use of animal data to quantitatively predict human risk and listed the methods from the literature that performed analytic linkage. The lack of analytic linkage in the literature might not be solely related to technological barriers including access to electronic database, statistical software packages, and Geographical Information System (GIS). Rather, the problem might be from a lack of understanding by researchers of the importance of animal data as a ‘sentinel’ for human health. Researchers performing zoonotic surveillance should be aware of the value of animal-sentinel approaches for predicting human risk and consider analytic methods for linking animal and human data. Qualitative work needs to be done in order to examine researchers’ decisions in linkage strategies between animal and human data.

Abstract: The tracking of sentinel health events in humans in order to detect and manage disease risks facing a larger population is a well accepted technique applied to influenza, occupational conditions and emerging infectious diseases. Similarly, animal health professionals routinely track disease events in sentinel animal colonies and sentinel herds. The use of animals as sentinels for human health threats, or of humans as sentinels for animal disease risk, dates back at least to the era when coal miners brought caged canaries into mines to provide early warning of toxic gases. Yet the full potential of linking animal and human health information to provide warning of such ‘shared risks’ from environmental hazards has not been realised. Reasons appear to include the professional segregation of human and animal health communities, the separation of human and animal surveillance data and evidence gaps in the linkages between human and animal responses to environmental health hazards. The ‘One Health initiative’ and growing international collaboration in response to pandemic threats, coupled with development in the fields of informatics and genomics, hold promise for improved sentinel event coordination in order to detect and reduce environmental health threats shared between species.

Abstract: OBJECTIVES: The goal of this systematic review was to identify evidence that animals could serve as sentinels of an attack with a chemical terrorism agent. METHODS: The biomedical literature was systematically searched for evidence that wild or domestic animals exposed to certain chemical weapons of terrorism had either greater susceptibility, shorter latency period, or increased exposure risk versus humans. Additionally, we searched for documented reports of such animals historically serving as sentinels for chemical warfare agents. RESULTS: For a small number of agents, there was limited evidence that domestic and/or wild animals could provide sentinel information to humans following an airborne attack with chemical agents, usually related to increased potential for environmental exposure. Some of this evidence was based on anecdotal case reports, and in many cases high quality chemical terrorism agent evidence regarding comparative susceptibility, exposure, and latency between humans and sentinel animal species was not found. CONCLUSION: Currently, there is insufficient evidence for routine use of animals as sentinels for airborne chemical warfare agents. At the same time, Poison Center surveillance systems should include animal calls, and greater communication between veterinarians and physicians could help with preparedness for a chemical terrorism attack. Further analysis of comparative chemical warfare agent toxicity between sentinel animal species and humans is needed.

Abstract: Linking human health risk to environmental factors can be a challenge for clinicians, public health departments, and environmental health researchers. While it is possible that nonhuman animal species could help identify and mitigate such linkages, the fields of animal and human health remain far apart, and the prevailing human health attitude toward disease events in animals is an “us vs. them” paradigm that considers the degree of threat that animals themselves pose to humans. An alternative would be the development of the concepts of animals as models for environmentally induced disease, as well as potential “sentinels” providing early warning of both noninfectious and infectious hazards in the environment. For such concepts to truly develop, critical knowledge gaps need to be addressed using a “shared risk” paradigm based on the comparative biology of environment-host interactions in different species.